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Updated: Mar 20, 2026

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Role of echocardiography in patients with stroke
Koki Nakanishi1, Shunichi Homma1
1Department of Medicine, Columbia University, New York, NY, USA.
Insights
Identifying cardiac sources is crucial for treating ischemic stroke and transient ischemic attack. Echocardiography plays a key role in assessing cardioaortic sources and guiding patient management.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Cardiogenic embolism is a significant cause of ischemic stroke, accounting for 15-30% of cases.
- Cardioembolic strokes are associated with high rates of recurrence and mortality.
- Potential sources include atrial fibrillation, cardiac tumors, and structural heart defects.
Purpose of the Study:
- To review potential cardiac and aortic arch sources of embolism in patients with stroke.
- To discuss the utility of echocardiography in evaluating these sources.
Main Methods:
- Review of literature on cardioaortic sources of embolism.
- Discussion of echocardiography techniques (transthoracic and transesophageal) for risk assessment.
Main Results:
- Various cardiac disorders and aortic arch pathology can lead to cardioembolic stroke.
- Echocardiography provides comprehensive data on thromboembolic risk.
Conclusions:
- Identifying cardioaortic embolic sources is essential for stroke management.
- Echocardiography is a vital tool in the clinical evaluation of stroke patients.
Abstract:
Investigation of potential embolic source is an important diagnostic step in treating patients with ischemic stroke and transient ischemic attack. Cardiogenic embolism has been estimated to be the causative factor in 15-30% of all cases of ischemic stroke. Cardioembolic strokes are generally severe and recurrence and mortality rate high. Various cardiac disorders including atrial fibrillation, ventricular thrombus, valvular heart disease, cardiac tumors, and structural heart defects can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually considered under source of cardiac embolism (cardioaortic source) and is reviewed in this article. Echocardiography (both transthoracic and transesophageal) is a widely used and versatile technique that can provide comprehensive information of thromboembolic risk in patients with stroke. This article reviews potential cardiac sources of stroke and discusses the role of echocardiography in clinical practice.
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